title: MR evaluation of fetal demise.
abstract: BACKGROUND
  Fetal demise is an uncommon event encountered at MR imaging. When it occurs, recognition by the interpreting radiologist is important to initiate appropriate patient management.
  
  
  OBJECTIVE
  To identify MR findings of fetal demise.
  
  
  METHODS
  Following IRB approval, a retrospective search of the radiology fetal MR database was conducted searching the words "fetal demise" and "fetal death." Fetuses with obvious maceration or no sonographic confirmation of death were excluded. Eleven cases formed the study group. These were matched randomly to live fetuses of similar gestational age. Images were reviewed independently by three pediatric radiologists.
  
  
  RESULTS
  The deceased fetus demonstrates decreased MR soft-tissue contrast and definition of tissue planes, including loss of gray-white matter differentiation in the brain. The signal within the cardiac chambers, when visible, is bright on HASTE sequences from the stagnant blood; the heart is small. Pleural effusions and decreased lung volumes may be seen. Interestingly, the fetal orbits lose their anatomical round shape and become smaller and more elliptical; a dark, irregular rim resembling a mask may be seen.
  
  
  CONCLUSIONS
  Although fetal demise is uncommonly encountered at MR imaging, radiologists should be aware of such imaging findings so prompt management can be instituted.
authors.affiliation: Department of Radiology, The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19103, USA. victoria@email.chop.edu
authors.forename: Teresa
authors.initials: T
authors.lastname: Victoria
authors.forename: Elena
authors.initials: E
authors.lastname: Capilla
authors.forename: Nancy Anne
authors.initials: NA
authors.lastname: Chauvin
authors.forename: Ann M
authors.initials: AM
authors.lastname: Johnson
authors.forename: Sandra Sue
authors.initials: SS
authors.lastname: Kramer
authors.forename: Monica
authors.initials: M
authors.lastname: Epelman
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005313:Fetal Death; D005865:Gestational Age; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008423:Maternal Age; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D012189:Retrospective Studies